Revenue Cycle Insider

General Surgery Coding:

Sort Out Global Package Status Indicator Confusion

Question: I’m new to coding and I’m still not clear on the global surgery packages. Could you please explain the global package and the different status indicators?

Minnesota Subscriber

Answer: Sure! The global package includes preoperative, intraoperative, and postoperative services for surgical procedures. Depending on whether the procedure is major or minor surgery, the preoperative and postoperative periods will vary. Also, physicians may provide services included in the global package at any location, such as a physician’s office, hospital, or ambulatory surgical center (ASC).

The global period includes how many days the postoperative period lasts. Postoperative periods are 0, 10, or 90 days depending on the surgery classification for the procedure. While most commercial payers adopt the global package concept established by Medicare, the individual payer policies may differ if the global period applies to surgeries.

Medicare specifies that the preoperative period for a major surgery is one day before the procedure and a 90-day postoperative period. Minor surgeries list the preoperative period as the day of the procedure followed by a 0- or 10-day postoperative period.

The status indicators tell you what the postoperative period is or if the global concept applies to the specific code, such as:

  • 000: These procedures include endoscopies and minor procedures with preoperative and postoperative relative values for the day of the procedure.
  • 010: These are minor procedures with a preoperative period consisting of the procedure day and a 10-day postoperative period.
  • 090: These are major procedures with a 1-day preoperative period and a 90-day postoperative period.
  • MMM: These are maternity codes, to which the global period usually does not apply.
  • XXX: The global period does not apply to these codes.
  • YYY: These are unlisted codes, which are subject to individual pricing.
  • ZZZ: These are add-on codes, which are related to another service and are included in the primary procedure’s global period.

Mike Shaughnessy, BA, CPC, Production Editor, AAPC

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